Provider Demographics
NPI:1801547336
Name:SIDE BY SIDE COUNSELING & CONSULTING LLC
Entity type:Organization
Organization Name:SIDE BY SIDE COUNSELING & CONSULTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT, THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:XIAOFANG
Authorized Official - Middle Name:
Authorized Official - Last Name:WANG LANTERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCMFT
Authorized Official - Phone:240-222-1529
Mailing Address - Street 1:6203 EXECUTIVE BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:NORTH BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3906
Mailing Address - Country:US
Mailing Address - Phone:240-222-1529
Mailing Address - Fax:
Practice Address - Street 1:6203 EXECUTIVE BLVD
Practice Address - Street 2:
Practice Address - City:NORTH BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20852-3906
Practice Address - Country:US
Practice Address - Phone:240-222-1529
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-17
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDFQ42-0000OtherCAREFIRST BCBS
15106320OtherCIGNA